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Animal-related injuries remain a neglected public health issue in rural Tanzania, exacerbated by limited access to care and varied occupational exposures. While some studies have examined bite management in tertiary hospitals, little is known about the situation at the primary healthcare (PHC) level. This study explored clinical presentations, management and outcomes of animal-related injuries in a rural Tanzanian setting, using Mkinga District as a case study. A mixed-methods study was conducted in February 2024 across 29 PHC facilities in Mkinga, Tanzania. The quantitative component involved a retrospective audit of animal-related injury records from 2019 to 2023. The qualitative component comprised 10 interviews with facility in-charges to explore clinical decision-making, treatment approaches, and outcomes. Quantitative data were analyzed using SPSS; thematic analysis was applied to the qualitative transcript. A total of 351 cases were documented. Symptom data were missing in over 70% of records, limiting clinical profiling. Among recorded cases, corticosteroids (55%) and antihistamines (53%) were commonly used, especially for insect and dog bites. Antibiotics were administered in insect stings (26%) and dog bites (23%), and analgesics were frequently used for insect bites. Antidotes were most common in dog (58%) and snake bites (26%). Of two cat bite cases, only one received antibiotics; neither received tetanus toxoid, despite the known infection risk. Qualitative findings highlighted three themes: clinical presentations, treatment modalities, and outcomes. Respondents described primary (e.g., bleeding, pain) and systemic (e.g., respiratory distress, neurological signs) symptoms. Treatment involved a mix of pharmacological, non-pharmacological, and traditional methods. While most patients recovered, some experienced complications or death. PHC facilities manage most animal-related injuries effectively, but gaps in documentation, guideline adherence, and referral systems remain. Strengthening provider training, improving resources, and engaging traditional healers may enhance timely care. Broader surveillance and community education are critical to reducing preventable harm.

ABSTRACT Background In 2018, the World Health Organization (WHO) called on member states to assess the burden of animal-related injuries. Tanzania is among the countries with no adequate data. This study sought to assess the burden of venomous bites and stings in a rural setting in Tanzania. Methods A retrospective study was conducted in February, 2024 to gather information from 29 selected primary healthcare (PHC) facilities in one rural setting. We used a checklist to retrieve data on venomous bites and stings from 2019 through 2023 from the patient records. Results Of the 476,928 patient records screened, 212 (0.04%) were identified as cases of venomous bites and stings. The majority of cases (n = 72, 34%) occurred among individuals aged 25–44 years, and 111 (52%) were male. Snakebites accounted for the largest proportion of cases (n = 63, 30%), followed by bee stings (n = 27, 13%), wasp stings (n = 15, 7%), and scorpion stings (n = 14, 7%). Number of recorded venomous bites and stings ranged from 30 in 2019 to 61 in 2023. Conclusion Despite their low overall incidence, the rising trend of venomous bites and stings highlights the need for strengthened surveillance and targeted prevention efforts.

BackgroundFish constitutes a nutritious food that deteriorates quickly when poorly preserved. Several biochemicals, including formaldehyde, accumulate naturally in the fish post-mortem. Apart from this natural formaldehyde, reports reveal the deliberate addition of formalin (37% formaldehyde solution) to the stored fish as a preservative. This is risky to consumers since formaldehyde is carcinogenic, genotoxic, and a potentiator of other carcinogens.AimThis study aimed to assess both the organoleptic quality and formaldehyde content of mackerels, the most consumed fish in Dar es Salaam, Tanzania.MethodsA total of 60 mackerel samples were conveniently and equally obtained from the local markets, street vendors, and supermarkets in five districts of the Dar es Salaam region. Organoleptic quality was evaluated based on organoleptic characteristics. Formaldehyde analysis was done by High-Performance Liquid Chromatography (HPLC). Analysis of variance was subsequently run to test the variation of formaldehyde content in mackerel by outlet type and district.ResultsAll analyzed mackerel samples had acceptable levels of organoleptic quality (2.46 ± 0.50) and a mean formaldehyde concentration of 10.89 ± 2.44 mg/kg. On average, the samples from supermarkets had the highest level of organoleptic quality (2.20 ± 0.21) but were also the most contaminated with formaldehyde (16.07 ± 4.68 mg/kg), while those from local markets were the least contaminated (3.91 ± 1.86 mg/kg) (p = 0.000). Moreover, 0% (n = 0), 20% (n = 4), and 35% (n = 7) of samples from local markets, street vendors, and supermarkets, respectively, had formaldehyde concentrations above 20 mg/kg, the previously estimated highest concentration for naturally formed formaldehyde in fish.ConclusionMackerels marketed in Dar es Salaam have acceptable organoleptic quality but are substantially contaminated with formaldehyde. Whether this is natural or artificial formaldehyde, our findings are inconclusive given the conflicting global standards. Nonetheless, the findings reveal the potential exposure of fish consumers to formaldehyde. Future research should explore the dynamics of the accumulation of natural formaldehyde in marketed fish and accurately assess the risk associated with the exposure of consumers to the formaldehyde in fish. The emanating findings will ultimately guide the development of local guidelines for natural and permissible formaldehyde concentrations in fish and fish products in Tanzania.

Background This study aimed to analyzed healthcare providers’ (HCPs) experiences in managing animal-related injuries, including bites and stings, focusing on challenges and opportunities in rural Tanzania. Methods In February 2024, an exploratory qualitative study was conducted at selected primary health care (PHC) facilities in Mkinga District, Tanga Region, as a proxy of a rural setting in Tanzania. Ten HCPs in the selected facilities were in-depth interviewed using an interview guide. All interviews were audio-recorded, transcribed, and analysed using a thematic approach. Results From the experiences of HCPs, the challenges identified include reliance on traditional treatments, low community awareness of available services, out-of-pocket payment, and the high cost of antivenoms. Additionally, system and infrastructure limitations, workforce shortages, and a shortage of critical medical resources were revealed. However, opportunities exist to improve victim management. These include HCPs’ readiness to treat victims, engagement of community health workers, resource availability, and supportive financial policies. Conclusion Access to healthcare for victims of animal-related injuries in rural settings is limited by socio-cultural practices, poverty, and poor infrastructure. However, leveraging existing opportunities, including the readiness of HCPs, health insurance schemes, and functional cold chain systems, along with improving community awareness and road networks, could significantly enhance timely access to care among victims.

BackgroundThe Covid-19 pandemic and other emerging diseases increased the need to conduct clinical trials (CTs) to investigate appropriate treatments or prevention measures. One of the main barriers for conducting CTs in Africa is delays in regulatory and ethics reviews. Furthermore, existence of inadequate regulatory inspections of CTs to evaluate the integrity of data submitted to health authorities, protect patient safety, and assess the adequacy of site/sponsor quality systems to achieve the same. To this end, the ASCEND project assessed the level of competency and training needs for evaluating clinical trial applications (CTAs) and conducting clinical inspections in Tanzania. Moreover, to recommend interventions to bridge the gap. MethodsA descriptive cross-sectional study was conducted from February to June 2021 using an online survey to collect information on training needs and competencies. The population was 130 respondents from research, regulatory and academic institutions. ResultsOut of 130 approached respondents, only 69.2% (90/130) participated. The most common qualification of the respondents was a master’s degree (59%). Bachelor degree and PhD holders stood at 21% and 20%, respectively. The findings indicated that 94% of the respondents needed training on assessment of clinical data, 92.2% on product quality, 92.6% on statistical data, and 81.2% on understanding and using the checklist for Good Clinical Practice (GCP) inspection.These findings were used to develop two accredited short courses 70-hours (7-credits) each. The courses were CTAs assessment and GCP inspection. Consequently, 2-weeks short courses were conducted. Pre- and Post- course tests were administered to assess the training impact.ConclusionA pool of proficient assessors is important for quality reviews of CTAs and in timelines reduction. The short courses conducted were successful, and increased a pool of competent assessors and GCP inspectors in Tanzania. For further strengthening the regulatory capacity, additional training is recommended.

Diabetes mellitus is among the leading global health concerns, causing over 1.5 million deaths alongside other significant comorbidities and complications. Conventional diagnosis involves estimating fasting, random blood glucose levels and glucose tolerance test. For monitoring purposes, long-term glycaemic control has been achieved through the measurement of glycated haemoglobin (HbA1c) which is considered reliable and preferred tool. However, its estimation could be affected by haemoglobin types like HbA0, HbA2, and HbF concentrations whose magnitude remains unclear as well as other haematological parameters. As such, the current study determined the association between HbA1c and haemoglobin types and determined correlation between haemoglobin types and haematological parameters among patients with type 2 diabetes mellitus (T2DM) compared to healthy non-diabetic participants. In this cross-sectional study, participants [ n  = 144 (72 per group), ages 23–80 years] were recruited and the desired parameter measured. HbA1c and other Haemoglobin variants were measured using ion-exchange high-performance liquid chromatography (HPLC) by the Bio-Rad D-10 machine (Bio-Rad Laboratories, Inc). Haematological parameters were measured using the Celtac G MEK-i machine (Nihon Kohden Europe). SPSS version 27 (IBM Corporation, Chicago, Illinois, United States) was used for the analysis. Chi-square (χ 2 ) analysis, Mann-Whitney U test, Binary logistic regression and Pearson correlation were used to determine the differences between proportions, compare laboratory characteristics, associations and correlations respectively. With non-diabetics as the reference group, HbA1c was associated with increased HbA0 [OR = 1.509, 95% CI = 1.020–1.099, p  = 0.003] and increased HbA2 [OR = 3.893, 95% CI = 2.161–7.014, p  = 0.001]. However, there was no significant association between HbA1c and HbF [OR = 2.062, 95% CI = 0.873–4.875, p  = 0.099]. Further, haematocrit (HCT) had a negative correlation with HbAO and a positive correlation with HbAS in participants with controlled diabetes. Mean cell volume (MCV) and mean cell haemoglobin (MCH) had a negative correlation with HbF. MCHC (mean cell haemoglobin concentration) had a negative correlation with HbA2 in participant with uncontrolled diabetes. The study concluded that levels of various haemoglobin types should be considered while monitoring glycaemic control through HbA1c. Additionally, MCHC should be considered in individuals with high concentration of HbA2 among T2DM patients while interpretating results for HbA1c.